Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA; Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA.
Program in Medical Education, Harvard Medical School, Boston, Massachusetts, USA; Department of Medicine, Beth-Israel Deaconess Medical Center, Boston, Massachusetts, USA.
J Pain Symptom Manage. 2021 Oct;62(4):768-777. doi: 10.1016/j.jpainsymman.2021.02.014. Epub 2021 Feb 15.
Interprofessional education (IPE) prepares clinicians for collaborative practice, yet little is known about the effectiveness of postgraduate IPE.
This is the first study to describe educational outcomes of an interprofessional fellowship in pediatric palliative care. Objectives were to understand the experiences of postgraduate trainees in an interprofessional, clinical environment and to evaluate program effect on interprofessional competencies.
In this mixed-methodology study, we surveyed former fellows from 2002 to 2018 about their fellowship experience and perceived change in interprofessional skills. We performed qualitative semantic content analysis of fellows' responses about learning in an interprofessional context. We compared fellows' self-rated ability (5-point Likert scale), before and after fellowship, in 10 interprofessional competencies selected from the Interprofessional Education Collaborative's core competencies.
Response rate was 87% (41/47). Fifty-one percent of respondents were physicians, 29% were social workers, and 20% were nurse practitioners. Respondents reported significant improvement in all 10 competencies, with summed mean scores of 2.8 ± 0.6 prefellowship ("not very well prepared") and 4.4 ± 0.4 postfellowship ("very well" to "extremely well prepared") (t = 15.6, P< 0.0001). Effect size for each competency was greater than 1.9 (strong positive impact). The fellowship experience was characterized by dynamic educational relationships: peer relationships with interprofessional co-fellows, mentoring relationships with faculty, clinical relationships with patients and families, and collaborative relationships with the healthcare system. Benefits and challenges of IPE were associated with interprofessional roles, teamwork, patient care, and educational needs.
This study demonstrates the feasibility and effectiveness of an interprofessional postgraduate fellowship in preparing clinicians for collaborative practice.
跨专业教育（IPE）为临床医生的协作实践做准备，但对于研究生 IPE 的有效性知之甚少。
这是第一项描述儿科姑息治疗跨专业研究员经历的教育成果的研究。目的是了解在跨专业临床环境中研究生培训生的经历，并评估该计划对跨专业能力的影响。
在这项混合方法研究中，我们调查了 2002 年至 2018 年的前研究员，了解他们的研究员经历以及跨专业技能的感知变化。我们对研究员关于在跨专业环境中学习的回答进行了定性语义内容分析。我们比较了研究员在 10 项跨专业能力方面的自我评估能力（5 分李克特量表），这些能力是从跨专业教育合作组织的核心能力中选择的，在研究员参加和不参加研究员之前和之后。
回应率为 87%（41/47）。51%的受访者是医生，29%是社会工作者，20%是执业护士。受访者报告说，所有 10 项能力都有显著提高，在研究员参加和不参加研究员之前的总和平均得分为 2.8±0.6（“准备得不太好”）和 4.4±0.4（“非常好”到“准备得极好”）（t=15.6，P<0.0001）。每个能力的效应大小大于 1.9（积极影响较大）。研究员的经历以动态的教育关系为特征：与跨专业合作研究员的同伴关系、与教师的指导关系、与患者和家庭的临床关系以及与医疗保健系统的协作关系。IPE 的益处和挑战与跨专业角色、团队合作、患者护理和教育需求有关。
这项研究表明，跨专业研究生研究员在为协作实践做准备方面是可行且有效的。
